NPIMap

Organization Active NPI

Apple Valley Anesthesia Medical Group Inc.

  • Anesthesiology Physician
  • Apple Valley, CA
National Provider Identifier
1831106905
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
APPLE VALLEY ANESTHESIA MEDICAL GROUP INC.
Practice address
18300 Hwy 18
Apple Valley, CA 92307-2206
Phone
(760) 242-2311
Fax
(760) 242-9167
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Benilda De Asis, M.D.NPI 1427062389
Title
President
Phone
(760) 946-3210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X CA Primary

Addresses

Primary practice location

18300 Hwy 18
Apple Valley, CA 92307-2206

Mailing address

101 S 1St St
1000
Burbank, CA 91502-1938
Phone (818) 845-6206

Other identifiers 2

IdentifierTypeStateIssuer
GR0091390MedicaidCA
ZZZ03117ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831106905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S 1ST ST",
            "address_2": "1000",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021938",
            "telephone_number": "818-845-6206",
            "fax_number": "818-845-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 HWY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072206",
            "telephone_number": "760-242-2311",
            "fax_number": "760-242-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLE VALLEY ANESTHESIA MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DE ASIS",
        "authorized_official_first_name": "BENILDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-946-3210",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0091390",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ03117Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.